Preparing the conversation: I'm not sure

For clinicians, chaplains, and care-team members. The person may bring a Decision Brief that uses these same words. No patient account, and nothing on this page is saved.

Shape of the conversation

Shared decision-making model: make the choice visible, compare options, elicit values and preferences, decide together, and revisit. Agency for Healthcare Research and Quality, The SHARE Approach

Ask; do not assume

Ask whether faith, spirituality, culture, philosophy, or ethical commitments matter before showing tradition-specific material.
Never infer a treatment preference from a religious, cultural, racial, ethnic, disability, gender, or other identity label.

Priorities, in the words the person sees

No order and no right set. Mark what the person names, in their words. These labels match the person's Decision Brief.

Living longer. How important is more time, and what would make that time worthwhile?
Symptoms & comfort. Which symptoms or burdens matter most to reduce or avoid?
Function & participation. What activities, roles, or ways of participating in life matter most?
Thinking clearly. How important are alertness, memory, concentration, or ability to communicate?
Independence, support & place. What kind of help is acceptable, and where would you prefer care or recovery to happen?
Time. How do appointments, recovery, waiting, or treatment time affect the choice?
Treatment burden. What level of monitoring, procedures, travel, or daily treatment feels manageable?
Work, school & responsibilities. What responsibilities or routines need to remain possible?
Caring for others. Who depends on you, and how does that shape what is feasible?
Family & relationships. Who should be involved, and which relationships or family roles matter here?
Cost & financial strain. What out-of-pocket cost, time away from work, or financial uncertainty matters?
Fertility & sexual health. Could fertility, pregnancy goals, sexual function, or body changes affect this decision?
Privacy, voice & autonomy. How do you want information shared, and how much control or support do you want in the decision?
Faith, culture, ethics or worldview. Is there a belief, practice, community, ethical commitment, or philosophy you want considered?
Risk & uncertainty. How do you feel about uncertainty, rare harms, waiting, or the chance that a treatment may not help?
Language & being understood. In what language do you want complex conversations, and what would help you understand and be understood?
Meaning & what you leave behind. What gives this time meaning, and is there anything you want to record, finish, or pass on?

Questions the person may bring

Prepare to answer with numbers and sources where they exist, and to say where they do not.

What exactly are we deciding, and by when?
What are the reasonable options, including waiting or doing nothing differently for now?
What benefits, harms, burdens, and uncertainties matter most?
What information would make me feel better prepared for the next conversation?
Who else has a stake in this, and what role do I want them to have?
Is there someone who has faced a similar choice I could talk to?

If someone else is helping decide

What do we know about what this person has said they want, and what are we guessing?
If the person can take part, how can they be included as much as they want?
Who else should be part of this decision, and is there a named decision-maker?

Notes, by hand

What matters most, in their words

What they want to know, and how

Next step and when we revisit

Evidence in Values in Care for this moment: General shared-decision literature only. Questions draw on general shared decision-making guidance.

Values in Care is independent and educational. It does not provide medical advice. This is conversation preparation, not a validated patient decision aid, a clinical protocol, or a record of consent.

valuesincare.com/navigator